title: Is self-perceived HIV risk congruent with reported HIV risk among traditionally lower HIV risk and prevalence adult emergency department patients? Implications for HIV testing.
abstract: Because reliance on patients' self-perceived risk for HIV might mislead emergency department (ED) clinicians on the need for HIV testing, we aimed to measure congruency between self-perceived and reported HIV risk in a traditional lower prevalence, lower-risk cohort. A random sample of 18- to 64-year-old patients at a large academic urban ED who were by self-report not men-who-have-sex-with-men (MSM) or injection-drug users (IDUs) were surveyed regarding their self-perceived and reported HIV risk. Sixty-two percent of participants were white non-Hispanic, 13.8% Black, and 21.2% Hispanic; and 66.9% previously had been tested for HIV. Linear regression models were constructed comparing self-perceived to reported HIV risk. Among the 329 female ED patients, 50.5% perceived that they were "not at risk" for HIV, yet only 10.9% reported no HIV risk behaviors, while among the 175 male ED patients, 50.9% perceived that they were "not at risk" for HIV, yet only 12.6% reported no HIV risk behaviors. Only 16.9% of women and 15.7% of men who had no self-perceived risk for HIV also reported no HIV risk behaviors. Multivariable linear regression demonstrated a weak relationship between self-perceived and reported risk. Congruency between self-perceived risk and reported HIV risk was low among these non-MSM, non-IDU ED patients.
authors.affiliation: 1 Department of Emergency Medicine, Alpert Medical School and School of Public Health, Brown University , Providence, Rhode Island.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Pringle
authors.forename: Roland C
authors.initials: RC
authors.lastname: Merchant
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Clark
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D015999:Multivariate Analysis; D009511:New England / Q000453:epidemiology; D010465:Perception; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D012649:Self Concept; D012725:Sexual Behavior / Q000523:psychology*; D011795:Surveys and Questionnaires; D014505:Urban Population; D055815:Young Adult